A Comprehensive Multilevel Analysis of the Bucharest Early Intervention Project: Causal Effects on Recovery From Early Severe Deprivation

King, Lucy S.; Guyon‐Harris, Katherine L.; Valadez, Emilio A.; Radulescu, Anca; Nelson, Charles A.; Zeanah, Charles H.; Humphreys, Kathryn L.

doi:10.1176/appi.ajp.20220672

Cited by 13 publications

(4 citation statements)

References 43 publications

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“…A two-sample study that found children placed in highquality foster care had significantly higher IQ scores than those randomized to care as usual, in part, by higherquality caregiving and attachment security in childhood. King, L. S., Guyon-Harris, K. L., Valadez, E. A., Radulescu, A., Fox, N. A., Nelson, C. A., Zeanah, C. H., & Humphreys, K. L. (2022). (See References).…”

Section: Recommended Readingmentioning

confidence: 99%

“…Nevertheless, studying the effects of neglect on human development has been more difficult, as neglect is often embedded in a host of other adverse experiences, such as abuse, poverty, or parental substance use, making it difficult to disentangle neglect from other adverse events. Arguably, children raised in deprived institutional settings represents the purest example of psychosocial neglect, because they are fed, clothed, and sheltered in a setting that is physically safe, albeit impersonal and insensitive (King et al, 2022). The absence of nurturing care is the primary form of deprivation.…”

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confidence: 99%

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Romania’s Abandoned Children: The Effects of Early Profound Psychosocial Deprivation on the Course of Human Development

Nelson,

Fox,

Zeanah

2023

Curr Dir Psychol Sci

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Understanding the impact that early psychosocial neglect has on the course of human development has implications for the millions of children around the world who are living in contexts of adversity. In the United States, approximately 76% of cases reported to child protective services involve neglect; worldwide, there are more than 150 million orphaned or abandoned children, including 10.5 million orphaned because of COVID-19. In much of the world, children without primary caregivers are reared in institutional settings. We review two decades of research based on the only randomized controlled trial of foster care as an alternative to institutional care. We report that children randomly assigned to continued care as usual (institutional care) suffer from persistent deficits in social, cognitive, and emotional development and show evidence of disruptions in brain development. By contrast, children randomly assigned to foster care show improvements in most domains of functioning, although the degree of recovery is in part a function of how old they were when placed into foster care and the stability of that placement. These findings have important implications for understanding critical periods in human development as well as elucidate the power of the psychosocial environment in shaping multiple domains of human development.

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Section: Recommended Readingmentioning

confidence: 99%

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confidence: 99%

Romania’s Abandoned Children: The Effects of Early Profound Psychosocial Deprivation on the Course of Human Development

Nelson,

Fox,

Zeanah

2023

Curr Dir Psychol Sci

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“…Because of their strict inclusion and exclusion criteria, the authors however stress that their analysis likely underestimates the positive effects of deinstitutionalisation. Within the Bucharest Early Intervention project, where children were randomly assigned to a limited number of foster care placements or care as usual (remaining in the institution), a positive effect of foster care on internalising problems was found (King et al., 2023).…”

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confidence: 99%

Deinstitutionalisation: A global effort to improve developmental outcomes for children

Golm

2023

Adoption & Fostering

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The December 2023 issue of Adoption & Fostering includes an article from the English and Romanian Adoptees (ERA) study established by the late Professor Sir Michael Rutter (Rutter, 1998). The prospective longitudinal study follows a cohort of adoptees into young adulthood who experienced severe deprivation in Romanian institutions during their early life. The study published here explores the voices of a subgroup of the original participants who have become parents (Edwards, Kennedy et al., 2023). Their reaching parenthood makes us acutely aware of the passage of time. It is hard to believe that it has been over 30 years since the devastating pictures of children living under inhumane conditions in Romanian institutions were broadcast across the globe. The living conditions were filthy without sufficient food, interpersonal care or cognitive stimulation (Sonuga- Barke et al., 2017).In the years to come, the findings from the ERA studyinfluenced guidelines for clinical practice and diagnosis. Its data contributed to the reclassification of attachment disorders in the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2013), the NICE guidelines on attachment in children in care (National Collaborating Centre for Mental Health (UK), 2015) and the Practice Parameter for the American Academy of Child and Adolescent Psychiatry (Zeanah et al., 2016). It has become part of the AQA A-level Psychology syllabus and is included as a case study in many developmental psychology textbooks. Lastly, it inspired international campaigns for the deinstitutionalisation of children (e.g., Lumos, 2016).Sadly, neither institutional care, nor the factors that led to its establishment in Romania are a thing of the past. In an attempt to increase the population, the dictator Nikolae Ceaus , escu banned contraceptives and abortions, leading to almost a doubling of maternal death rates due to unsafely performed 'illegal' abortions. Families were often too poor to provide for their children and had to give them into the 'care' of the state (Hord et al., 1991). Looking at the political shift to the right in many countries (or within individual states in the

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“…Even though a minority of young children in the cohort have experienced any one type of violence exposure, 72% have experienced violence exposure of some kind by age 6. Since previous research has shown that there seems to be a tipping point for greatly increased risk of developing aggressive or violent behaviours around age 2 years (Waller et al 2017 1 ; King et al 2023 2 ), a strong international focus on preventing violence exposure, especially in babies and young children, is warranted if this intergenerational pattern is to be broken. A strong early childhood health and social care focus is likely to be necessary if communities like Drakenstein are to recover from colonialisation and apartheid.…”

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Early Childhood Violence Exposure Patterns in The Drakenstein Child Health Study (DCHS)

Tsunga,

Lake,

Halligan

et al. 2023

Wellcome Open Res

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Background: Research has highlighted high rates of exposure to violence among South African youth. However, work to date has been largely cross-sectional, focused on violence exposure during the adolescence period, and has been limited to specific types of violence exposure. We examined violence exposure in South African preschool children between 3 and 6 years of age, capturing both direct and indirect forms of violence, and tested for potential sex differences across the several types of exposures. Methods: Lifetime direct and indirect exposure to domestic and community violence was measured by parental report when children were 3.5 years (N = 530), 4.5 years (N = 749) and 6 years of age (N= 417) in a South African birth cohort located in a peri-urban community. Results: There are three main findings. First, a large proportion of children (72%-75%) were reported as having been exposed to some form of direct or indirect violent experience in their homes or communities from a young age. Second, there was significant polyvictimization, with 49% of the children being exposed to more than one type of violence by age 6. Third, by 4.5 years of age, there was evidence that boys were more likely than girls to be exposed to domestic victimisation (28% vs. 17%) and polyvictimization (38% vs. 28%). Conclusions: These findings highlight the high levels of violence exposure in young South African children, particularly among boys, and the need for prevention at both the community and individual levels.

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A Comprehensive Multilevel Analysis of the Bucharest Early Intervention Project: Causal Effects on Recovery From Early Severe Deprivation

Cited by 13 publications

References 43 publications

Romania’s Abandoned Children: The Effects of Early Profound Psychosocial Deprivation on the Course of Human Development

Romania’s Abandoned Children: The Effects of Early Profound Psychosocial Deprivation on the Course of Human Development

Deinstitutionalisation: A global effort to improve developmental outcomes for children

Early Childhood Violence Exposure Patterns in The Drakenstein Child Health Study (DCHS)

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